For low-income Medicare beneficiaries who do not qualify for SSI, Medicaid’s assistance is more limited, primarily covering Medicare premiums. This assistance is provided through the “Medicare Savings Programs” (MSPs), of which Qualified Medicare Beneficiaries (QMB) is one. QMBs receive help with premiums and cost sharing obligations.

Beginning in 2010, a state’s MSPs asset limits should match the full SSA low-income subsidy resource limits ($8,100 for an individual and $12,510 for a couple). However, these SSA limits automatically include the minimum federal burial exclusions ($1,500 for an individual and $3,000 for a couple). While SSA assumes that all applicants get this exclusion, many states do not automatically assume the exclusion for their MSPs and require proof, i.e, requirement for a separate designated burial account. Some states may also have higher burial account exclusions as well.

45 states, including DC, use the standard general income disregard of $20 when determining eligibility, which is added to the monthly income limit for the individual or couple.

FPL for a family of three in 2009: $18,310 for 48 contiguous states and District of Columbia, $22,890 for Alaska, $21,060 for Hawaii.

Medicaid Financial Eligibility: Primary Pathways for the Elderly and People with Disabilities, Kaiser Commission on Medicaid and the Uninsured analysis of data collected by Medicare Rights Center, 2009, February 2010. Available at: http://www.kff.org/medicaid/8048.cfm.

NA: Not Applicable.

1. Connecticut increased its general income disregards and eliminated its asset test to align the Medicare Savings Programs eligibility with that of its State Pharmacy Assistance Program.
2. DC’s large general income disregards effectively increase the QMB income limits to 300% of FPL and SLMB to between 100% and 300% FPL. Because QMB limits have been increased, SLMB only applies to the month of application and the three-month retroactive period prior to application that QMB cannot cover. Also, because QMB and SLMB limits were increased, no one qualifies for QI anymore. See http://www.dhs.dc.gov/dhs/cwp/view,a,1345,q,605559,dhsNav_GID,1728,.asp#2-2-1.
3. Maine’s QMB, SLMB, and QI income thresholds are still at the federal income thresholds, but under Section 1902(r)(2), the State calculates the general income disregards each year to effectively increase the income limits to 150% FPL (for QMB) , 170 % (for SLMB), 185 percent (for QI). Maine also has a general income disregard of $75 that applies on top of the income disregards used to raise the Medicare Savings Programs income limits.